The aim of the present work was to analyse the alterations of rhino-sinusal physiology in 106 professional athletes (swimmers, skiers, boxers and runners) using objective rhinological methods. Every athlete underwent an accurate anamnesis, a complete objective ORL evaluation, an active anterior rhinomanometry, an acoustic rhinometry and an evaluation of mucociliary transport time (MCTt). Skiers were also submitted to a nasal decongestion test (NDT). In swimmers, the mean MCTt was 27.4±4.97 min (normal value: 13±3 min; P<0.0001). The average MCTt for the skier group was 19.58±1.92 min (P<0.0001); the mean value of total basal nasal resistance was 0.37±0.05 Pa/ml per s (normal value =0.25 Pa/ml per s; P<0.001). After NDT, total nasal resistance was 0.18±0.02 Pa/ml per s. In the group of boxers, the total mean nasal resistance was 0.64±0.05 Pa/ml per s (P<0.001); the mean cross-sectional area at the nasal valve level was 0.57±0.04 cm2 (normal value =0.55±0.05 cm2) and at the inferior turbinate level 0.83±0.05 cm2 (normal value =0.4±0.04 cm2; P<0.001); the TMC average time was 27.35±2.21 min (P<0.0001). Finally, for the runners, the mean MCT time was 20.56±2.35 min (P<0.001). Knowing the alterations of the physiological nasal respiration is of extreme importance to develop a correct and timely therapeutic approach to be able to restore rhino-sinusal homeostasis. Athletes, in fact, need the earliest therapeutic aid in order to avoid the interference of prolonged rhino-sinusal alterations with their performance and also to avoid a more serious clinical situation concerning the inferior airways.